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华蟾素是一种从蟾蜍中提取的化合物,是一种传统的中草药,已被证实在癌症治疗中具有疗效.华蟾素注射液广泛应用于中国中晚期肝癌患者.本研究的目的是明确华蟾素注射液对这类特定患者的影响.在PubMed,EMBASE,CENTRAL和其他四个主要的中国数据库中检索使用华蟾素注射液治疗中晚期肝癌随机对照试验.根据Cochrane协作和RevMan 5.3的建议进行系统评价和Meta-分析.根据Cochrane手册计算风险比(RR)和相应的95％置信区间,使用随机效应模型来统计数据.最后共纳入了11项随机对照试验,728名患者.所有试验均显示,使用华蟾素注射干预组的总反应率,Kamofsky表现评分(KPS)的总反应率,1-2年生存率和生活质量均有明显改善.但是6个月生存率和临床受益率各组之间没有统计学差异.本研究发现华蟾素注射液对中晚期肝癌患者的总反应率和1至2年生存率的有益作用.因此我们认为华蟾素注射液治疗中晚期肝癌的疗效可能优于对照组.鉴于大多数试验质量较低,因此需要严格按照CONSORT for TCM设计的更高质量的前瞻性随机试验来进一步验证.“,”Cinobufacini,a compound extracted from bufo toad,is a traditional Chinese medicine (TCM) that has been shown to have efficacy in cancer treatment.The cinobufacini injection is widely used in patients with moderate and advanced liver cancer in China.In the present study,we aimed to determine the effects of cinobufacini injection for this specific category of patients.A search for randomized control trials (RCTs) using cinobufacini was conducted in the PubMed,EMBASE,CENTRAL,and the other four major Chinese databases.The systematic review was performed according to the recommendations of the Cochrane collaboration,and the RevMan 5.3.software was used for statistical analysis.A random-effects model was used to perform the data.Risk ratios (RR) with corresponding 95％ confidence interval were calculated according to Cochrane handbook.A total of 11 RCTs consisting of 728 patients were included.All of the trials demonstrated significantly improved total response rates,total response rates of Karnofsky Performance Score (KPS),1-to 2-year survival rates,and quality of life in the intervention groups injected with cinobufacini.There was no statistically significant difference between the groups (cinobufacini versus no cinobufacini;cinobufacini plus transcatheter arterial chemoembolization (TACE) versus TACE only) in terms of the 6-month survival rate,clinical benefit rate and clinical benefit rate of KPS.This systematic review demonstrated the beneficial effects of cinobufacini injection in terms of total response rate and the 1-to 2-year survival rate in patients with moderate and advanced liver cancer.The efficacy for the cinobufacini injection group might be better than that of the control group for treatment of moderate and advanced liver cancer.Given that the majority of the trials were of low quality,more high-quality prospective RCTs with strict design in accordance with CONSORT for TCM are needed.